Evaluation of the Reaching Out Project

(Barca-Leeds)October 2018

Final Report

"Depression and anxiety are crippling. It is like your head says get up and walk

but your limbs just can't do it. It is only as you feel better mentally that this

changes. Confidence to look after yourself and get better also gets stronger."

Reaching Out client

Richard Malfait and Nick Scott-Flynn (Independent Evaluators)

R. Malfait Consultants Ltd e mail: richardmalfait@aol.com Telephone: 07808 297859

Contents

Heading Page

Introduction and acknowledgements 3

Evaluation context, aims and methodology 4

Executive summary (with recommendations) 5

Summary of findings on the Reaching Out, activities and outputs to date 8

Value and strengths in approach and delivery model 10

Impact and difference made against planned outcomes 16

Looking ahead - context, future needs and priorities 22

Future context and access to support 22

Support issues, needs and priority groups 25

Partnership approach (stakeholder comments) 27

Learning and improvement points (stakeholder suggestions) 28

Concluding comments 31

Appendix One: List of contributing stakeholders

Appendix Two: Service user response counts

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Introduction and acknowledgements

This report presents the findings of an independent final evaluation of the Reaching Out Counselling

and Psychotherapy Project delivered by Barca-Leeds. The project was established in January 2016

with funding from the Big Lottery (BLF). It is in its third and final year which will conclude in January

2019. At the time of writing this report the Reaching Out Project had provided support to more than

300 individuals. The report summarises feedback from stakeholders on the value, strengths and

impact of the Reaching Out Project. It also outlines the context, challenges, learning points and

future needs for consideration in planning for the future work. These findings form the basis for our

recommendations.

The final evaluation was commissioned and overseen by Kelsey Trevethick, Service Manager for

Counselling and Psychotherapy at Barca-Leeds. It was undertaken by Richard Malfait and Nick Scott-

Flynn (independent evaluators and project support consultants) between May and September 2018.

The purpose of the evaluation was to identify project strengths, impact and learning.

Contributing stakeholders were invited to share their experience and views on needs and issues to

inform recommendations that would support future planning and development by Barca-Leeds.

The evaluation findings and recommendations draw upon our review of relevant monitoring data

and reports coupled with feedback gathered from multiple sources including paid and unpaid team

members (volunteers) working to deliver Reaching Out services, other staff in Barca-Leeds and

practitioners in external stakeholder organisations. Stakeholders who were consulted also included

32 individuals who received therapeutic support from Reaching Out through individual counselling

or participation in support groups.

The evaluation would not have been possible without the help and participation of all the

contributing stakeholders and we are grateful to everyone, especially the volunteers and service

users, who gave their time and shared their views in the consultation process.

Finally, Barca-Leeds would like us to express their thanks to the Big Lottery for the funding and

support they provided, without which Reaching Out could not have been delivered.

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The following abbreviations are used throughout the report: MH - Mental Health; IAPT - Improving

Access to Psychological Therapies (service).

Evaluation context, aims and methodology

Reaching Out is a Big Lottery funded counselling project provided by Barca-Leeds. The current

contract started in January 2016 and is due to end in January 2019. One to one counselling and

group sessions are provided free of charge to people in need in postcodes LS12, LS13 and LS281. A

wide range of indicators identify these postcodes areas as the most deprived parts of the city of

Leeds with poor health, life expectancy and higher levels of chronic diseases. Individual counselling is

often long term, spanning 24 weeks and is for individuals with high needs. The group sessions

include Cognitive Behaviour Therapy (CBT), a group supporting men to manage their anger issues, a

group providing therapeutic support and a support network for highly vulnerable adults.

The overall evaluation purpose was to highlight the successes of the Reaching Out Project and to

identify learning to inform future service delivery. The evaluation report will also be used to provide

feedback to the Big Lottery Fund, health commissioners and other interested stakeholders. Specific

tasks included in the evaluation process and presented in this report were set out in the evaluation

specification provided by Barca-Leeds. They were (summarised):

Review the aims and actual delivery of the service

Outline the changing context of Leeds both during the period of the service and looking

ahead to the future

Assess the efficacy and value of the service to the client group

Evaluate the overall success and impact of the service

Identify what has been learned

Make recommendations about the need for this type of service based on the value to clients

and the strategic context in Leeds

The evaluation scope, process and consultation questions were jointly designed with Barca-Leeds. In

total 73 stakeholders participated in the evaluation consultations (see table below). We have also

reviewed participant and stakeholder feedback examples gathered routinely throughout the project

implementation.

1 LS12, LS13 and LS28 - Armley, Bramley & Stanningley and Farnley & Wortley

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Internal and external stakeholders and service users were identified by Barca-Leeds. Participation of

all stakeholders was voluntary and individuals were told that their feedback and contributions would

be made anonymous and not specifically attributed to individuals either in discussion with Barca-

Leeds or in the evaluation report. A summary of stakeholder group participation is shown in the

following table:

Stakeholder input / data category

Services users who have engaged with individual counselling 18

Service users who participated in group sessions 22

Service users who participated in both individual and group based sessions 4

Reaching Out team members (paid and unpaid) 8

Other Barca-Leeds staff (not delivering Reaching Out services) 5

External stakeholders (e.g. based in referring and peer organisations) 16

Total 73

Executive Summary

Feedback from the 73 stakeholders who contributed to the evaluation has been consistently and

emphatically positive on the immense value and effectiveness of the individual and group based

therapeutic support provided by Reaching Out. Across the range of stakeholders, from service users,

referring organisations to staff and volunteers, Reaching Out has been described as both life-

changing and lifesaving.

In addition to the feedback from stakeholders, the desktop review of management reports and

monitoring data (both quantitative and qualitative) confirms that Reaching Out has achieved (or

directly supported) the aims and outcomes set out in its funding application to Big Lottery in 2016.

There are clear and emphatic statements from all stakeholder groups, that the combination of

individual and group based support provided by Reaching Out continues to be relevant and highly

needed. An empathetic but constructively challenging approach was also identified as a valuable and

differentiating factor in the experience of those who felt that they had benefitted more through

their Reaching Out experience than in their experience of other styles and providers of counselling.

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Wide-ranging links with referral agencies have been established and the Reaching Out service has

become a highly respected, trusted, and vital referral resource in its localities. This has been

reflected in the year on year increases in referrals received, especially of individuals who have been

unable to access Improving Access to Psychological Therapies (IAPT) and other mental health

support due to not meeting applicable criteria. Stakeholders across all groups, including mainstream

providers, consistently reported that there is no similar service offering comparable, free, accessible

and long term support of this nature in the Reaching Out delivery postcodes. The level and

complexity of presenting need has grown throughout the project delivery and is expected to

continue and grow in the future. This expectation is also reflected in research and policy statements

at both a local, city and national level.

94% of responding service users felt that coming to Reaching Out has helped or is helping

them achieve the changes or aims that they hoped for when they first asked for help.

(Evaluation survey)

91% 'strongly agreed’ or 'agreed' that coming to Reaching Out "helped me to feel better or

happier in myself". (Evaluation survey)

The main challenges and learning points identified in the evaluation relate to long waiting times

coupled with suggestions that referral pathways and initial assessment practices could usefully be

reviewed. There were suggestions that these could benefit from being adjusted to check and ensure

that people in highest and most urgent need can access help as quickly as possible.

Stakeholders also highlighted the growing recognition of linkage between early childhood trauma

(especially physical and sexual abuse related) and the range of issues, needs, parenting, family and

life difficulties that are common to a high proportion of people asking for mental health support.

There is a shared interest in exploring the feasibility of developing targeted and specialist support for

people sharing a background of early trauma.

The Reaching Out service model is evidently both effective and cost efficient. It is dependent upon

and enriched by the energy, diversity, time and skills of volunteer counsellors working alongside and

with support from paid team members. The professionalism, skills and commitment of the Reaching

Out team has been evident throughout the evaluation, has been acknowledged and is highly

respected both by service users and practitioners in peer organisations.

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Recommendations

The following recommendations draw upon our analysis of monitoring data and stakeholder

feedback recorded throughout the delivery of Reaching Out and additionally in our consultations

with stakeholders as part of this evaluation.

1. Resource and continue to deliver the combination of individual and group based therapeutic

support and counselling currently provided by Reaching Out - there is ongoing need, the

model works and the service provides vital, life-saving and changing support for vulnerable

and high risk individuals. Strategic and policy priorities at local, regional and national level all

acknowledge the need for mental health service development and accessibility as a priority.

2. Aim to increase service capacity, especially for the provision of individual therapeutic

support and counselling - the level of demand throughout the delivery of Reaching Out has

been consistently higher than can be expediently responded to. Stakeholder feedback

confirms a perceived need for more capacity.

3. Review the current 'open referral' arrangements and consider creating a more specific

referral pathway (for example through GPs) - in order to check and ensure that waiting times

for the most vulnerable and at risk people seeking urgent support are reduced.

4. Review initial assessment practices and explore ways of removing or helping people

overcome barriers to engagement with support (both before and after asking for help). For

example, addressing barriers linked to mistrust and nervousness about asking for help, meet

and greet experiences, timings of group sessions, location, travel, costs, child care etc.

5. Further explore research relating to the linkage between early childhood trauma and

negative impact in later life (e.g. on parenting, physical and mental health) - and consider

piloting or establishing a service model that can target and respond to identified needs.

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6. Continue to review research relating to linkage between mental and physical health and the

potential for dual benefits through the provision of therapeutic support, interventions and

activities.

7. Further explore the development of closer partnership based work and more closely

integrated funding arrangements with GPs, other NHS and voluntary sector mental health

support organisations and Social Care teams (working with children, adults and families).

8. Continue to monitor and ensure that all team members access appropriate and effective

supervision and support according to their roles and needs. Evaluation feedback was very

positive in this area and any future service development should ensure that adequate

budgets, supervision skills and capacity are built in.

9. Check 'meet and greet' practice in the reception areas of service bases to ensure consistency

in welcomes and arrival advice. Evaluation feedback was almost exclusively positive from

service users on their experience of engaging with Reaching Out. However, two individuals

commented that on the occasion of their first visits (when they felt nervous and hesitant)

they had not been met or greeted in the reception area.

10. Review and consider the cross stakeholder evaluation and feedback on future needs,

priorities, learning and improvement suggestions and planning considerations - these are

summarised in this report.

11. Share and celebrate the evaluation feedback from stakeholders with the Reaching Out team

- their dedication, compassion, skills and professionalism in providing life-saving and life-

changing support are consistently acknowledged and appreciated by service users and other

support providers in Leeds.

Summary of findings on the Reaching Out, activities and outputs to date

Summaries of the main support and activities through which Reaching Out aimed to achieve its

outcomes are set out below:

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"It's made me think and understand about what can trigger my depression. I haven't been down since I started coming (to counselling with Reaching Out)." Counselling client

Provision of individual counselling sessions for 100 adults/young people experiencing complex

social disadvantage, to a maximum of 24 sessions: The project supports the mental health and

emotional wellbeing needs of men, women and some young people who live in areas of severe

disadvantage. NHS reported in 2011 ‘Higher levels of poor mental health and wellbeing and mental

illness are inextricably linked with deprivation within Leeds. Reaching Out has received 704 referrals

in total with 342 received in year two and 73 currently open. Demand for the service continues to be

high and feedback is very positive. The numbers of individuals accessing the service who report

unsuccessful treatment through IAPT or being deemed too complex to work with is increasing.

"My councillor is fantastic at what they do. They have never lost patience with me even when I have shut down or stopped engaging during sessions. They are caring, kind, strict but fair and non-judgmental. They will speak openly and honestly with me with whatever we discuss. They have supported me incredibly well both during our sessions and outside of them. They are a credit to your service and I only wish there were more people like them within the mental health service." Counselling client

The Positive Communication Group: Reaching Out provided therapy to adults experiencing deep

social exclusion within an open group structure, supplemented by outreach activities. Thirty five

individuals have attended this group. LS12 has the highest prevalence of suicide across all areas of

Leeds so the project runs from a Community Centre in this area. The group addresses issues of; low

self-esteem, negative thoughts, isolation, victimisation, risk taking, harmful behaviours, anger, low

mood, suicidal thoughts and suicide ideation. The group's focus is on helping people to find their

voice. Each week the group agrees themes for discussion which can include many current affair

issues and other more philosophical discussions with every member given opportunity to speak. The

group is much more than a space to meet every week, friendships are formed and people care for

one another. The group has set up a buddy system so if somebody hasn’t been seen for a day their

buddy will call them or call round to their home to check in on them.

"I know a lot of nice people because of coming this group. It's a focal point and you know it's on the same day and time every week. People come and go. They stop coming for a while sometimes but then start coming again. The trips (group) are really good. We've been to London and Scotland (and other places). We help each other and we get out. My dad and kids come sometimes." Group participant

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The Anger Management Therapy Group: The Yaya (You And Your Anger) group is for men only and

helps them identify the origins of their anger, situations that make them angry and practical

methods to enable them to manage their behaviour. To date 81 referrals have been received and 51

individuals have attended the course. Referrals have been received from: Self; Community Mental

Health; GP’s; Probation; IAPT; Psychotherapists; Counsellors; Social care. The group is facilitated by

two trained and experienced counsellors one female and recently for the first time, one male. The

psychoeducational sessions provide a platform for the men and as trust is built up each week

through the non-judgmental approach offered, members feel they can look at other areas in which

their behaviour has caused difficulties. These have included relationships with their partners and

children. Their insight and awareness around anger and how it can be used in a healthier way allows

the men to make informed decisions about their behaviour and empowers them in a positive way.

Through checking in each week the men begin to share more and more and this is worked through

with whole group input. Three group members have made a film providing detailed feedback about

their involvement with the group which can be viewed here https://www.youtube.com/watch?

v=AXLb4pxOIHs&feature=youtu.be

"I'm closer to my kids now (after coming to the group) and the rest of my family has noticed that I talk more and am more in control of my emotions and anger. Before they'd stopped inviting me to family things like weddings and barbeques." Group participant

CBT/Mindfulness Therapeutic groups: These sessions have been provided for disadvantaged adults

to identify and change negative thought patterns and associated behaviours. To date 72 people have

attended in total. Referring Agencies: Self, GP, Forward Leeds (Drug and Alcohol Service), St Annes

Community Services, Barca Counsellors, Housing Workers, Probation services, Better Leeds

Communities, PEP, Talent Match Worker, Family Drug and Alcohol Court Team (FDACT). The

facilitator has been very proactive in attending team meetings to promote the service across the

area. This has resulted in a number of referrals from other agencies. Reaching Out has now booked

to deliver the next course in a Children’s Centre. The process of working together on recruitment

has strengthened Barca-Leeds relationship with the area and they are now receiving referrals from

the Children’s centre so have now based one of the Counsellors on site to deliver 1:1 therapy in the

community.

"It has helped me develop mindfulness techniques that help me negotiate my everyday life in a more positive way. I enjoyed being part of a group with common ideals. " Group participant

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Value and strengths in Reaching Out approach and the delivery model

Forty four service users contributed in final evaluation consultations. These included individuals who

engaged with Reaching Out to receive individual counselling and others who were participants in the

anger management, mindfulness and positive communication group sessions. Feedback on the value

and impact of Reaching Out was consistently very positive with the exception of one individual who

did not feel that they had benefited from the service. A summary of responses is presented in

Appendix Two2. Sixteen stakeholders from external organisations and thirteen from Barca-Leeds

(including Reaching Out team members) also contributed in evaluation consultations. The main

themes and messages expressed from across the evaluation stakeholder groups are summarised

below:

The reputation of Barca-Leeds and Reaching Out: Stakeholders consulted in external organisations

clearly value and respect the work of Barca-Leeds generally and specifically Reaching Out. Barca-

Leeds is commissioned to deliver therapeutic services in 7 out of 22 schools clusters across Leeds

and has a long standing and good reputation with other local mental health providers both locally

and in other areas. Its good reputation locally is felt to have helped make the service more

approachable and accessible to individuals that wouldn’t normally seek this type of support.

"Barca are very good at multi service work and partnership work. Because Barca offer such a holistic variety of support they are very valued within our community and Leeds as a whole. Some services are restricted by location due to funding restrictions but this is out of their control and down to funding provider stipulations. The whole city could benefit from all Barca services." External stakeholder

Cost effectiveness: This evaluation hasn't included a detailed analysis of project costs and benefits.

However, it is clear through basic review of the budget, the team structure and project activities that

the service delivery model is both effective and financially efficient. The model largely relies upon

and benefits from the skills of 16 trained, Volunteer Counsellors (supervised by paid team members)

providing their time for free.

2 Appendix Two: Service user response counts

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Ability to access both group based and individual support: Stakeholders in all groups identified this

a valuable strength in the structure and delivery of Reaching Out. Several reflected that considering

participation in any form of group but especially one with a therapeutic function can feel

uncomfortable and daunting. Reaching Out stakeholders described how in many instances

throughout the implementation of the service, individuals might move from individual counselling

into group participation or vice versa because of changing needs or levels of confidence and

understanding of process.

(Strengths? ...) "Their ability to make and sustain relationships with people encourages them to attend and continue with therapy. Opportunities to move on to other aspects of the service for follow-up, such as Mindfulness, or Anger group." External stakeholder

Counselling support for up to 6 months: The number of counselling sessions (up to 24) available for

individuals was highly valued both by those engaging in counselling, team members in Reaching Out

and also other support workers and professionals in external and referring organisation. All agreed

that this model was necessary in enabling trust and honest communication to be established and for

the counselling experience to be beneficial.

"The longer-term counselling means I can breathe a bit with it and not worry that I have to fix everything in six or eight sessions. Also, being able to come outside of work hours as ensured that it hasn't caused more stress and allowed me privacy about it at work. I cannot say how grateful I am for those things." Counselling client

Group based support: Previously recorded feedback and final evaluation feedback from current and

former participants from each of the Reaching Out groups emphasises the value and effectiveness of

this aspect of project delivery. This was also a theme in feedback from other stakeholders. Some

individuals reflected that they were initially reluctant or very nervous about joining a group but were

happily surprised at how much they came to enjoy and benefit from participation. The groups enable

people to meet others and develop friendship and support networks. They were also recognised for

being time and cost effective in enabling more people to access support than could solely be

reached through individual counselling.

76% of responding stakeholders rated the value or impact of group based therapeutic

support provided by Reaching Out as 'high'. 24% said 'I don't know" (usually because they

knew less about this aspect of the service). Evaluation survey

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"I understand the value of not feeling alone when struggling. People benefit in so many ways from the group bases sessions. Some examples are: exploring issues, normalising, socialising, breaking down barriers of anxiety, building confidence, feeling understood, feeling a sense of belonging and forming positive relationships." External stakeholder

"We work with hard to engage people, sometimes excluded from services due to their behaviour and options for people wanting to make change is limited. The numbers of referrals for our groups again has grown year on year and feedback shows that peer support is invaluable and significantly supports growth and change. We have a number of desperate individuals that call our service looking for specific support. Group support is a more cost-effective way or providing this support than one to one." External stakeholder.

Free, specialist support for people who cannot access other services: The value of Reaching Out as

a free and accessible service as expressed across all the stakeholder groups. The poverty levels in the

areas of Leeds within which the project operates are amongst the highest in Leeds. Several project

users (of both individual and group therapy) indicated that they had not been able to access other

services (including IAPT) for different reasons. These included being above or below mental health

needs thresholds, as a result of previous behaviours or due to service charges. These points were

also made by Barca-Leeds team members and stakeholders in referring organisations. Several

commented that the numbers of people asking for mental health support is increasing whilst the

availability of free support remains sparse and is becoming harder to access (due to tightening

criteria, service funding and waiting times). Reaching Out is therefore highly valued both for being

accessible (though waiting times can be long) and free to those who live in the designated post code

areas.

"It was wonderful. 24 sessions. I knew she'd set me up and get me through the winter. Like a pair of slippers! My friends had had enough (of me being down and talking). The counsellor pushed me - she didn't hold back. But they also told me I was educated, kind, intelligent... I felt very lucky to get one to one counselling." Counselling client 

Empathetic but challenging approach: Several counselling clients volunteered that they had found

the counselling process and approach to be challenging at times. However, they identified this as a

strength of the service and in several instances clients felt that this approach was instrumental in

helping them better understand themselves (which consequently enabled them to develop better

prevention and coping strategies). The empathetic but constructively challenging approach was also

identified as a valuable and differentiating factor in the experience of those who felt that they had

benefitted more through their Reaching Out experience than in their experience of other styles and

providers of counselling.

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"I got a counsellor that I feel comfortable with. They've got me thinking about the causes - this hasn't happened and it’s not worked out before (in other counselling). I had a counsellor (somewhere else) but there was just silence. Here it's challenging - you explore the roots of problems. " Counselling client 

Central community base: Reaching Out has been primarily coordinated and delivered from its main

service base in Bramley. This has been the location in which most group sessions and individual

counselling have taken place. Service users and support providers identified its central, relatively

easy to reach location (on public transport or by walking) as one of the service's strengths. Several

service users in the community based group discussions agreed (with each other) that the work of

Barca-Leeds Reaching Out feels very embedded in the community and is something that is

specifically 'for them' as residents.

"It (this group) helps me because of what I've been through. We talk to each other and I feel listened to. Sometimes we have debates! It helps people who are isolated to meet people. When someone doesn't come for a while someone will check up on them to make that they're OK." Group participant

Commitment, team ethos and expertise: The Reaching Out services have been delivered by a team

that is comprised of a part time Manager, two part time Senior Counsellors, 14 Volunteer

Counsellors and two student Counsellors (one of whom is doing a Doctorate in Psychology and one

is completing a Diploma in Counselling). All the team members (paid and unpaid) are qualified in

their roles and many are highly experienced. The expertise, skills, professionalism and commitment

to its client group of the Reaching Out team became evident through our own evaluation

consultations and observations with team members but was also explicitly stated by clients, group

members and external stakeholders.

"The team of counsellors are genuinely passionate about the people they work with, all highly skilled and experienced and I have 100 percent faith in referring any of my clients to the service. " External stakeholder

"There is something special about the Barca team ethos. There is no distinction between employed team members and volunteers, all are equally valued. Peer support, training, CPD and team building opportunities are superb." Reaching Out team member

Volunteer expertise and contribution: Senior staff and other paid team members in Reaching Out

stressed the critical importance of the skills and dedication of volunteer counsellors who are

embedded in the service delivery model. Without them, Reaching Out simply would not be able to

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offer the range and volume of expert support and counselling that it does and waiting times for

those needing to access the service would be significantly longer. Volunteer counsellors not only

enable Reaching Out to reach more people but they also bring added diversity to the team. All are

qualified, and experience levels range. Those who are more recently qualified are able to build up

their experience and skills in a well supervised environment.

"(My counsellor) has gone out of their way to secure a counsellor for me to only work on a specific day to suit my schedule. I was a bit worried when I found out they were a trainee counsellor as I naively didn't want them to be using me as a "practice" person, but I really am so pleased with my counsellor- they have helped me question things that I wouldn't usually think of and I am seeing an improvement to my mental health." Counselling clientQuality of supervision and commitment to learning: Several stakeholders commented explicitly on

the quality of support and supervision that they received both formally through line management

and clinical supervision arrangements but also informally from team colleagues. A professional

culture that values learning, reflective practice and service improvement was also very evident in

evaluation team consultations with Reaching Out and other Barca-Leeds stakeholders.

Filling a support gap (and referral relationships): Stakeholders in all consultation groups

emphasised the importance of Reaching Out both as a referral resource to which other support

providers could make referrals but also as a referring partner able to connect individuals to other

essential services. Review of referral records confirms that the number of agencies making referrals

to Reaching Out has increased each year since it was established. Examples of referring agencies are

listed under the summary of activities for individual and group support and includes social care

agencies, the probation service and other services such as IAPT. Professionals in other agencies often

call Reaching Out to discuss potential referrals or seek advice on available options. As noted

previously, Reaching Out is often able to accept referrals and provide support for individuals that do

not meet access criteria that apply in other service provision (because they assessed as either too

complex or not complex enough). Several external stakeholders identified the ease of making

referrals to Reaching Out as a strength. Whilst most reported that communication on the status of

referrals for individual support was effective, two commented that referral status and response

times could be better communicated. Several external stakeholders and service users also

commented that whilst they understood that capacity is limited, waiting times for support were

sometimes too long.

Monitoring and evaluation: There is an evident commitment to monitoring and evaluation,

including consultation with service users on both an internal, routine basis but also supplemented by

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independent evaluation at key stages (this final evaluation for example). Consequently, Barca-Leeds

and Reaching Out have been able to capture and evidence activity, impact and learning throughout

the project delivery on both a quantitative and qualitative basis. Evolving context and future needs

are also monitored and identified through the same approach.

Impact and difference made against planned outcomes

90% of responding stakeholders (not service users) rated the value or impact of one to one

counselling and support provided by Reaching Out as 'High'. (Evaluation survey)

The activities of Reaching Out aimed to achieve the following outcomes:

Outcome one

People using the service will report improvement in daily functioning - greater self-care,

healthier lifestyle choices, reduced self-harm/risk taking, beneficial changes in psychotropic

medication.

People using the service will report improvement in symptoms associated with

depression/anxiety - greater pleasure in activities, increased energy and improved sleep.

Outcome two

People using the service will report an improvement in daily functioning – increased motivation

to explore and take up opportunities (social, recreational, educational, employment

People using the service will report improvement in symptoms associated with low self-esteem –

social withdrawal, sensitivity to criticism, preoccupation with personal problems, aggressive

outbursts.

Outcome three

People using the service will report an improvement in daily functioning – greater self-care,

reduction in risk taking/harmful behaviours, effective use of coping strategies.

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People using the service will report a decrease in symptoms associated with trauma, abuse and

neglect such as flashbacks, panic attacks, nightmares, suicidal ideation.

Outcome four

People using the service will report an improvement in relationship functioning - confidence to

leave abusive situations, increased assertiveness, and better quality relationships.

People using the service will report improvement in symptoms associated with difficulty in

relationships – improved communication, reduced conflict, anger and aggression, reduced social

isolation.

To ascertain whether the Reaching Out Project achieved these outcomes, the project has embedded

monitoring and evaluation practices in its approach and implementation including the adoption and

use of Reaching Out 'Core Benchmarks'. Core uses a combination of sector-specific national averages

to enable services to compare their own results on a number of indicators with aggregated data for

similar services within Primary Care (PC). The data demonstrates that the service intake level is 2.03

(69) showing that clients start on average at a moderate to severe level, higher than the national

average intake rate of 1.81 (61). The service has worked hard to increase the data received in order

to evaluate success and now have a 58% rate of completion of pre- and post-therapy CORE-OM

which is 16% higher than the national average. Top line data has been reviewed and discussed with

Reaching Out managers as part of this evaluation. It clearly indicates that the services and support

provided by the project are effective (no comparison has been made with similar service provision).

Similarly, Reaching Out delivery has been routinely monitored and reported on against the target

outcomes and outputs included within the original project funding application to the Big Lottery.

This data along with qualitative feedback gathered from all stakeholder groups has also been

reviewed as part of this evaluation. Again, in summary, it is clear that target outputs and project

beneficiary numbers have been met or surpassed against each outcome. The qualitative data and

feedback from service users is consistently positive and again clearly indicates that Reaching Out is a

vitally important service that is effectively delivering on its purpose and target outcomes and

provides highly valued, sometimes lifesaving support for those using it (and other referral partners).

93% of responding service users felt that coming to Reaching Out has helped or is helping

them achieve the changes or aims that they hoped for when they first asked for help (final

evaluation survey).

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In our evaluation consultations, we asked all stakeholders groups to consider and comment on

value, impact and difference made or supported by Reaching Out. The qualitative feedback upon

which our evaluation conclusions are based is summarised below. It clearly indicates that the aims

and outcomes of Reaching Out have been achieved:

It helps save lives: Interviews and online survey responses from people who have engaged with

Reaching Out include feedback that as result of their experience of individual or group support, their

thoughts and the likelihood of self-harm including suicide have been reduced. This was also noted in

the experience and feedback of Reaching Out team members and referring professionals. Most of

those who are referred to and supported by Reaching Out are recognised as being at medium to

high risk of self-harm and sometimes suicide. It is clear from stakeholder and service user feedback

that Reaching Out support has probably helped to save lives.

70% of responding service users ‘strongly agreed’ or 'agreed' that coming to Reaching Out

"... reduced or helped me cope with any feelings about hurting myself" (Evaluation survey)

"The counselling was a really important part of my early recovery and has helped me immensely. Lifesaving stuff. Literally." Counselling client

"I went from black to grey to yellow." Counselling client

"It brings a ray of light into my life and helps me understand things from a different perspective. Gives me some hope." Counselling client

It helps individuals and families build and rebuild relationships: Reaching Out group work and

counselling has helped individuals better understand and manage their mental health including

sometimes finding new ways to more appropriately manage anger and other emotions. Several

individuals have felt that these changes have been instrumental in helping them make positive

changes including returning to work and education, building new relationships, repairing old ones.

Three men who were participants in Reaching Out's anger management group helped to make short

films that shared their stories and the positive impact the group has had on their lives. For one of

the men, the negative impact of his anger almost destroyed his relationship with his wife and forced

him to leave the family home. They are now back together and things are very different. Similarly,

two other members of the group have been re-united with their children and now enjoy improved

interpersonal relationships.

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86% of responding service users ‘strongly agreed’ or 'agreed' that coming to Reaching Out

"... helped me learn things or improve life skills that will be useful in future e.g. In

relationships, at work etc." (Evaluation survey)

It helps people to understand their mental health and develop coping strategies: One of the most

common responses from group members and individual support clients when we asked about

'difference made' was that they had been helped to better understand themselves. Several told us

that they came to realise the value and importance of identifying often traumatic life experiences,

cognitive and day to day behaviours that possibly contributed to their mental and emotional health

issues. As noted previously, the supportive but also honest and challenging approach of counsellors

and group facilitators was identified as a key strength in approach. The comparatively high number

of sessions available to people in support groups and in individual counselling was felt to offer

sufficient time for service users in both categories to explore root causes but also to shape

preventative and coping strategies with their counsellors, group facilitators (and peers).

Consequently, stakeholders from all groups but most notably perhaps amongst service users, feel

they are better able to recognise when they are most vulnerable or heading for a difficult period of

mental health. Sometimes they are able to change patterns or reduce impact and be more resilient

in their day to day lives.

86% of responding service users ‘strongly agreed’ or 'agreed' that coming to Reaching Out

"...helped me to take better care of my mental or emotional health".

76% 'strongly agreed’ or 'agreed' that coming to Reaching Out "... helped me manage

difficult emotions and feelings like anger, depression or anxiety." (Evaluation survey)

"In the group sessions, they give you tools and help you think about consequences that you've probably not thought about, like losing your family - the domino effect from anger. Sometimes you come out and feel raw, empty. But it gives you more to think about. Group members help each other and the therapist works gently. Nobody judges or shames you. You can say things you'd normally only say to yourself." Group participant

"It's shown me how to deal with things in a different way and I was able to stop drinking. I don't want to go back to how I was before. It helps you pick up the pieces. Counselling helps you learn how to deal with things. I feel more in control. " Counselling client

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It enables people to talk, share and listen: Feedback for both group participants and individual

counselling clients emphasised the benefit experienced through feeling able and encouraged to

speak openly about traumatic experiences and emotions such as anger, anxiety and depression.

Some of those interviewed and using the online survey felt that this in itself was one of the most

important benefits of their engagement with Reaching Out. Several indicated that previously in life

they either felt unable or hadn't been allowed to talk so openly either as result of stigma, familial

culture and norms or lack of understanding. In contrast, in Reaching Out environments, people

described feeling encouraged to talk (and listen), safe, accepted, listened to and not judged either by

counsellors, group facilitators or peers.

"When they said, I could have 24 sessions I sighed with relief. Was so exhausted. One to one talking really helped. The first thing (counsellor) said was 'I won't be doing anything for you - the time is just for you to talk. It was great - I'd been brought up to not talk about myself." Counselling client

"Having a safe space once a week where I can share my thoughts and feelings has help massively. Speaking with a trained councillor who doesn't judge me or my actions and is eager to help and support me has really helped me learn more about myself. Counselling client

It helps people build (or re-build) confidence and self-esteem: Review of internally gathered

feedback from groups confirms that individuals who previously felt isolated have made friendships

and now go out more. Increases and improvement in confidence and self-esteem is also reported in

feedback. Several service users described a lack of or loss of confidence and self-esteem which they

linked to their mental and emotional health generally or specific incidents and periods of illness.

Each felt that the work they had engaged in with Reaching Out groups or counselling had helped

them build or rebuild their levels of confidence and self-esteem.

86% of service users who expressed a view think that mental health services can help to

improve physical health.

62% of service users think that coming here (to Barca/Reaching Out) has helped or is helping

them to improve their physical health or how they feel about their health issues. (Evaluation

survey)

It helps people feel physically better and be more active: When asked whether they felt there is a

link between their mental health and physical health or wellbeing, 78% of service users said that

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there is. Most commented that part of the difference made through engaging with Reaching Out was

that they felt physically better and were experiencing fewer aches, pains or bouts of illness.

74% of responding service users ‘strongly agreed’ or 'agreed' that coming to Reaching Out

"... helped me to take care of my physical health and fitness". (Evaluation survey)

"If you feel good mentally you are more likely to get up and go for a walk for example, rather than sitting inside all day. Therefore, I do think the better you feel inside, the better you feel outside." Counselling client

"Improved mental well-being generally goes alongside physical health improvements. It’s been a while since attending BARCA & my motivation to improve my physical health is low at the moment. I need to get involved in more social activities that include physical activities. " Counselling client

It gives something positive for people to look forward to: Several individuals who experience cycles

of severe anxiety or depression told us that their scheduled meetings with counsellors or

participation in group sessions became increasingly important during periods when they could be

feeling at their lowest and quite desperate. The contact with counsellors, group facilitators and

peers was something that they could look forward to or at least 'hang on' for in the hope and

knowledge that they usually felt better afterwards. Evaluation discussions with one community

based group highlighted this impact value on several levels. Members emphasised how much they

enjoyed being part of the group both for the weekly updates on life, conversations, debates, fun,

trips out and general sharing of problems, ideas and support. Several compared being part of the

group as like being part of a wider family.

"After the weekend, I feel emotionally bloated and I want to get it all out!" Group participant

"Being isolated, I was aiming to go out and mix and communicate with people, and mindfulness has helped along the way" Group participant

"I keep bright lights on and the curtains open all the time at home. Else I'm fourteen hours in the dark on my own. You can buy a light box for a £100 but who wants to sit in front of a light box?" Counselling client

It helps people build or rebuild support networks and reduces loneliness: Again, individuals from

both types of service user group described how their involvement with Reaching Out had often

helped them build or rebuild social and support networks. Reaching Out team members and external

stakeholders made similar observations. This was often helped through the experience of coming

into contact with other local people visiting Reaching Out - many were experiencing similar

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difficulties in terms of their mental and emotional health but also in relation to addiction, isolation,

housing, money, work etc. People told us that they had come to realise that others were often

having similar struggles, had encountered and were working through similar experiences and

problems. Talking, listening, sharing, reflecting, supporting and problem solving amongst peers

seems to have been both a planned and organic element in the Reaching Out group work approach

and general experience.

"This group is fantastic. We're like a family and we listen to each other. I know that I can tell people what my week has been like and how I'm feeling - and that they'll listen to me. Give advice and make suggestions too." Group participant

"When the doctor told me I was terminal I locked myself away for six months. Someone from the group came and got me out. Started coming here and talking. It's like one family. And it's focussed on our area." Group participant

"There was only (my dog) keeping me alive. My husband died a while back. Then my budgie. On my 50th wedding anniversary I didn't get a card from anyone. I was devastated - but I just kept going." Counselling client

It links people into other networks and services: Stakeholders across all groups described this as

one of the most important areas of value and impact for Reaching Out. Many of those engaging with

Reaching Out for individual counselling and group based support also present with a range of

problems relating to housing, work, physical health (etc. as listed previously). Reaching Out team

members are able to effectively signpost and make referrals to other resources and support

organisations in order to help ensure that clients and group members can access the help they need.

Looking ahead - context, future needs and priorities

86% of responding service users felt that individual and group based support like that

provided by Reaching Out will be needed in the future? (Evaluation survey)

93% of responding stakeholders (based in organisations) rated the level of future need for

one to one counselling and support as provided by Reaching Out, as 'high'.

86% rated the level of future need for group based therapeutic support as provided by

Reaching Out as 'high'.

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Reaching Out team members, practitioners and professionals in other stakeholder organisations

were asked to consider and comment on the strategic context, learning points and future needs that

they would like Barca-Leeds to consider in their planning and development processes. The main

response themes are summarised below:

Future context and access to support

Strategic and policy context: A significant UK wide focus on mental health is reflected in national

strategies including 'No Health Without Mental Health (2011); Achieving Better Access to Mental

Health Services by 2020 (2014)' and 'Mental Health Crisis Care Concordat (2014)'. At a local level the

Leeds Health and Wellbeing Board has identified 'Improving people’s mental health and wellbeing'

as one of four 'commitments' which it believes will make the most difference to the lives of people in

Leeds. 'The Mental Health Framework 2014-2017’s Vision' cites the provision of Community Based

Mental Health Services as one of four main priorities, acknowledging that the current wait for talking

therapies is too long (Leeds MIND and Leeds Women’s Counselling have closed their waiting lists at

the time of writing). Leeds West CCG have expressed their intention to invest in community based

Mindfulness provision in the future ('Developing Population Based Approaches to Mental Illness

Prevention in the Leeds West Population.' Hortynska and Hugh-Jones, September 2015). On a

strategic and policy level, there is a clear recognition of support and services that adequately and

effectively respond to the needs of people who are at risk of or experiencing mental illness.

Increasing need, harder access to support across Leeds: In evaluation consultations, almost without

exception, service users and practitioners within Barca-Leeds and other external support

organisations agreed that the level and complexity of mental health support needs in Leeds are

increasing. Team members and practitioners both internally and in other organisations described

increasing difficulties (and waiting times) in accessing any form or level of mental health support.

This was mainly attributed to a combination of perceived funding difficulties or cutbacks both in

mainstream and voluntary sector provision and tightening support eligibility criteria by support

providers (e.g. IAPT). Certainly, the numbers of individuals seen by Reaching Out who report

unsuccessful treatment through IAPT or being deemed too complex to work with is increasing. Some

feel that the sparseness of resources and support has been compounded by the impact of austerity

measures, benefit caps and similar changes in national policy, all of which has placed many families

and individuals under increasing levels of financial hardship and mental stress.

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"Life seems to be becoming more pressured, stressful, less stable. Cuts to social services and public services means someone needs to help people falling through the gaps. They're not getting enough of the help they need and it is going to put more pressure on people to support family and friends and we're not equipped to for some things." Group participant

"From my experience working with mental ill health (for both myself and others) and speaking with other services there is a huge demand for this type of service at the moment and not enough to go around." Counselling client and support provider

Further contributing factors to increases in needs and demand on specialist support are felt to be

increasing awareness, understanding and acceptance of mental illness and the potential

effectiveness of help amongst the public. Whilst several respondents commented on the persistence

of stigma and shame felt by people experiencing mental illness, some felt that increasingly there is a

growing willingness to ask for help resulting in increased demand and pressure on services.

Stakeholders across all groups consistently anticipated that the level and complexity of mental

health support needs across Leeds will continue to grow for the foreseeable future.

"I think times are hard for some people and I truly believe depression, anxiety etc. Is becoming so much more talked about and therefore the more groups like this that are available, the more people will use the service and therefore struggle in silence less." Group participant

"Demand management should be considered so that a long waiting list does not build up. Demand is very high for MH services - it has followed increasing awareness, reducing taboo and cultural acceptance in society." Barca-Leeds stakeholder

"There is increasing recognition of mental health difficulties among the public, this has led to more people identifying they have a need around their mental health that hasn't been met. Alongside this, there are fewer resources, and the resources that we do have in terms of NHS services (Leeds IAPT and the Psychology & Psychotherapy Service) have stringent criteria around suitability that mean a lot of people fall between the gaps." External stakeholder

Evidence of need and case for targeted delivery in Reaching Out post code areas: Reaching Out has

provided individual and group based therapeutic support in the post codes of LS12, LS13 and LS28

(Armley, Bramley & Stanningley and Farnley & Wortley). In evaluation consultations with

stakeholders we asked whether there is ongoing and wider need in Leeds for the type of support

provided by Reaching Out. Many felt that there is wider need across Leeds for this type of service

but there was also a clear and strong preference for the current delivery areas to be prioritised in

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future planning and delivery. These are areas of severe disadvantage where at least a quarter of

LSOAs3 are within the most-deprived 10% of LSOAs in England. A recent NHS report ‘Mental Health

and Wellbeing in Leeds: An Assessment of Need in the Adult Population’ states:

“Higher levels of poor mental health and wellbeing and mental illness are inextricably linked with deprivation within Leeds. Local mapping highlights these issues and emphasises the social gradient of mental health and wellbeing” (Leeds NHS report, 2011, p.5).

Most Reaching Out service users that fed into the evaluation responded that they were either not

aware of similar free support provision or that they could not access it (often due to eligibility

criteria, distance or cost). The Reaching Out project has received high volumes of referrals from

Leeds PCMHT4 and IAPT services for some time, reflecting the confidence that these organisations

have in its expertise supporting individuals with moderate to severe levels of difficulty and need. A

recent report from the Leeds North Clinical Commissioning Group (September 2015) stated that:

“At present at least a third of referrals are inappropriate for IAPT…. due to being too complex for the type of treatment available…. This cohort of service users commonly fall into the following categories: Low risk personality disorders, eating disorders, bereavement, anger management, low risk historical sexual assault, previous unsuccessful treatment through IAPT.” Barca-Leeds stakeholder

Some Reaching Out service users indicated that they chose not to ask for help from other

organisations because they had used them before and found (or expected) them to be unsuitable or

ineffective for them. One evaluation respondent had previous experience of paying for local private

counselling and had found some value in it. Others indicated that paying for counselling or other

forms of therapeutic support would not be feasible for many residents in the Reaching Out

catchment areas which experience some of the highest poverty and depravation levels in Leeds. The

lack of free and quickly accessible expert mental health and therapeutic support for residents in the

Reaching Out post codes (and across Leeds generally) was also confirmed by practitioner

stakeholders.

Support issues, needs and priority groups

3 LSOA: Lower Super Output Areas (LSOAs) are fixed statistical geographies of about 1,500 people designed by the Office for National Statistics (ONS).

4 PCMHT: Primary Care Mental Health Team

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We asked evaluation stakeholders to identify future needs, issues and priority groups that they

would like Reaching Out or Barca-Leeds to include in future planning discussions. Monitoring of

needs throughout the delivery of the Reaching Out Project over the three-year period has enabled

Barca-Leeds to record and track the most common and key issues that present in their work with

individuals and groups. These were also reflected in stakeholder feedback and include: complex

childhood trauma (physical, emotional, sexual abuse); relationship breakdown; parenting difficulties;

including children removed to social care; PTSD5; flashbacks, panic disorders; undiagnosed chronic

mental illness; difficulty managing violent and aggressive impulses; high level risky behaviour, self-

harm and lack of self-care; inability to leave violent and abusive relationships; chronic social

isolation, loneliness; offending behaviour; substance misuse; depression, anxiety; low self-esteem;

suicidal ideation, planning and suicidal acts; feelings of abandonment and invisibility.

Evaluation stakeholders suggested the following client groups for consideration as priorities in future

planning and service development processes:

Parents – a need for parents to understand the impact of their life experiences on their own

mental health and subsequent impact on their children.

Individuals that have experienced trauma that continues to impact on their daily lives.

Males and females who struggle to manage their emotions such as anger in particular.

Parents who have children going through care proceedings.

Individuals who present repeatedly at their GP’s with psychosomatic illness

Early childhood trauma: Many of the issues and needs identified through service monitoring and

evaluation consultations (identified in the preceding paragraph) can be interconnected. Clients and

group members often experience and need support in relation to combinations of several such

issues. Reaching Out and external practitioners particularly identified connections between early

childhood trauma and increased vulnerability to poor physical and mental health and many other

difficulties in later life. Certainly, a high proportion of the clients that attended Reaching Out have a

significant history of adverse childhood events and trauma which have negatively effected their day

to day lives. Links between early childhood trauma and difficulties in parenting are widely

acknowledged and reflected in stakeholder comments. Several advocated the importance of early

support for people affected by childhood trauma and suggested the research and development of

new, enhanced and targeted services as a priority.

5 PTSD: Post-Traumatic Stress Disorder

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"Childhood trauma. Key group. From my work, we're seeing generations of adults that went through trauma as child who don't know how to function and a healthy way - struggle in parenting. It's a cycle - hard to cope with day to day life. Could break cycle but needs to include some work with whole family. Reaching Out is supporting the parents and working with us with re other family members." External stakeholder

Linkage between mental and physical health: Evaluation consultations also explored (not in depth)

service user and other stakeholder views on perceived or experienced based linkage between

mental and physical health or sense of wellbeing. 86% of service users indicated that they do think

that their mental health and physical health are inter-connected, each affecting the other positively

or negatively. Again, this was identified as a possible area for further research and possible service

development in future.

"Depression and anxiety are crippling. It is like your head says get up and walk but your limbs just can't do it. It is only as you feel better mentally that this change. Confidence to look after yourself better also gets stronger. Also, it helps you to put yourself first more to go to the doctors or make time to walk etc. I am certain health worries I had this year were due to depression and anxiety, counselling has helped me to listen to my body and close the door on stressful situations... most of the time." Counselling client

Partnership approach (stakeholder comments)

General agreement was expressed on the value of Barca-Leeds exploring opportunities for and

developing closer partnership working with GP's, other mental health support organisations and

practitioners both in Reaching Out post code areas but also more widely across Leeds. An aim and

criteria for strengthening formal and informal partnership approaches and models would be to

ensure and improve client accessibility to integrated specialist provision such as that offered by

Reaching Out. Building future sustainability in funding and service provision by Barca-Leeds would

also be an aim of this approach with clear benefits for both clients, their communities and other

support organisations.

Several stakeholders both within Barca-Leeds and externally expressed interest in partnership based

service development possibly between Barca-Leeds and social care teams (children and adults) that

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aims to offer therapeutic support for parents and families struggling with issues relating back to

early childhood trauma. Similarly, some stakeholders suggested value in Barca-Leeds working in

partnership with other local counselling services to ensure best possible integration and accessibility

of support.

Other stakeholder suggestions for partnership based development and initiatives included:

Looking at secondary MH services. Working with Primary care practitioners. Making sure

that people get referred to the right place. Working with people to offer groups.

MH services like IAPT. Just to make MH services a bit more connected - seamless service.

GP surgeries and healthcare services as there is a noticeable link between mental and

physical health for many people.

MIND - always closing the waiting list for counselling.

Better links with GPs for referrals.

Any organisation that can be developed to work in symbiosis would always benefit our

service users. I believe referral networks for organisations that support substance misuse,

housing, debt, occupational health and physical health would be the major target areas.

Local communities and drop in centres.

Social services and other counselling supportive charities.

Closer partnership with GP services and NHS Mental health services.

Leeds IAPT and the Psychology & Psychotherapy Service.

Learning and improvement points (stakeholder suggestions)

All stakeholder groups were asked to identify possible areas for improvement in Reaching Out's

approach and service model. General feedback was consistently very positive and relatively few

learning points and improvement suggestions were made. The most common related to long waiting

times and referral pathways for access to Reaching Out. This theme is outlined in the paragraph

below. Other suggestions and comments were made but there was no obvious or recurring theme.

They are nonetheless relevant and are simply listed for review and consideration by Barca-Leeds.

Comments on Reaching Out waiting times and referral pathways: Inter-connected with the

challenges and contextual changes outlined in the preceding paragraphs are the continually high

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(and growing) numbers of support requests made directly by individuals or received through

referrals made by GPs and other mental health or generic support workers. Many people who are

referred to or who directly approach Reaching Out for individual counselling are desperate for help

and in many instances, have been assessed as being at high risk. Self and third party referrals are

routinely screened on receipt by Reaching Out and every effort is made to see those in need as

quickly as possible (usually within two weeks). However, it has proved impossible to keep up with

and meet the level of demand for individual counselling and consequently a waiting period of several

months for individual counselling is not uncommon. On several occasions throughout the three-year

period of implementation, the waiting list and receipt of referrals have had to be temporarily closed

due to the level of demand until existing clients have completed their period of support. When asked

to offer suggestions on ways that Reaching Out or similar services in future could be improved,

stakeholders in all groups consistently asked for a reduction in waiting times for support for those

most at risk and in most urgent need. A Barca-Leeds stakeholder suggested that future planning

include a review and possibly change to the current 'open referral pathway' arrangement. To date,

both professionals across the city and individuals within the project delivery post codes can make

referrals or refer themselves into Reaching Out. This offers good accessibility in one respect but also

contributes to high waiting times due to numbers on the waiting list and means the project cannot

quickly respond when clients most need help and are motivated to access help.

From Reaching Out users

Hopefully reducing the waiting time to see a councillor would help greatly

I think they could advertise more about the services that are available. I am interested in the

Mindfulness programme but can’t see it advertised anywhere on the website. I think there

are leaflets in the reception of Barca but that is no good if you don't ever go there? People

need to know more about what a great service this is and that it is available to them

I think the service is one of the best I’ve used. I think that it's is pretty much optimised the

way it is

In one to one sessions the offer of more support and coping strategies to help with day to day

routines and life would be beneficial.

It would help SO much if there were times available outside working hours, or if not then

later in the day. I am self-employed and the timings meant I lost pretty much a full day due to

the nature if my business.

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It would be nice to have a mindfulness practice group on a regular basis to follow on from

the group I attended

The referral time was quite long (6 months approximately).

The waiting time (to see a counsellor)! It took 1 year and 8 months for me to access Barca.

When help is needed, it's needed now. Quickly. They need secure funding.

There needs to be support provided (interventions) when kids are young - respond to needs

and problems early on.

The only thing I'd change is when you first come - sometimes there is no one in reception

(only been someone the last two times I came). I was very nervous and could easily have

walked away. That and the waiting time - I had a nine month wait. Would be better if it was

shorter waiting time and if you knew where you were on the list (updates on the waiting

time).

Do something about the entry - I have stood waiting often to get in as rarely is the door

phone answered and I have to wait for somebody who works in the building to let me in as

they are re-entering the building - this can be very off-putting for somebody who has issues

with rejection for example.

The counselling isn't long enough (some people need more sessions).

It'd be good if they could help people take steps to get back into work.

I would like to see more arts and crafts and encouraging people to join in to show their skills.

We all have something to offer.

More groups and arts and crafts.

Longer term therapy for those people that need it. Although Barca has helped me

tremendously I was not able to address all the difficulties and issues which I needed to.

From other stakeholders (Barca-Leeds and external stakeholders)

Moving forward it would be helpful to liaise more with them to look at what is needed -

developing a counselling approach we can work with. Consultation with practitioners about

specific cases.

Would be good if some of our clients were able to access group support more easily (not just

places left).

Counsellors are moving towards conducting their own assessments prior to therapy starting.

This reduces the number of individual service users need to interact with, and reduces the

occasions for them to tell their story.

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I had to leave numerous messages/emails to check on progress of referrals I had made. It

took me a few weeks of contacting before someone did get back to me.

Referral process- specific referral pathway. We operate an open referral pathway currently,

meaning both professionals across the city and individuals within our postcode areas

(funding) can refer in. This shows the high demand for the service but results in high waiting

times due to numbers on the waiting list. This means we are unable to respond when

perhaps the client is motivated.

Holistic assessments – a need to work differently in terms of managing people’s practical

barriers which can sometimes get in the way of them getting the full benefit of the therapy.

In terms of gaps in support – with the very nature of the client group make them ‘hard to

engage’. Clients have been exposed to abuse and victimisation they are scared to seek

support and also accept it, many are still living chaotic lifestyles this causes issues around

engagement and attendance. I feel there is more support in the build-up to accessing

therapy that could be done.

Communication within the organisation could be improved. Team meetings are an important

feature of working in the organisation and these have not been as regular as they used to be.

It feels e-mails have replaced talking and such a lot can be misinterpreted through the

written word - talking is much better.

More refined referral process and screening criteria.

Learning points would be, not run two groups on different days of the same.

I think maybe we need to get a clearer way forward on liaising with other professionals that

our clients are involved with.

I believe for the service that we offer, more regular contact with the manager 3 x a year

would be helpful for our contract to be reviewed regularly.

Website for BARCA - the Reaching Out counselling service - clearer links with clearer

telephone numbers. Many of our Care coordinators at CMHT don't know what you offer

unless I tell them so it might be worth you updating people.

Concluding comments

We hope that this report provides a useful description of the impact, achievements, challenges and

learning identified through Reaching Out's Big Lottery funded work over the past two and three

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quarter years. We also hope that it provides material that will prove to be useful in informing future

planning, development and service or project delivery. All the internal stakeholders working in

Reaching Out have engaged very openly, reflectively and constructively throughout the evaluation

which is greatly appreciated. There is a shared and passionate commitment to providing effective

support and relief from suffering for vulnerable people in the Reaching Out postcodes. Team

members (paid and unpaid) should be justifiably proud of their work and in the invaluable difference

it makes for so many people who engage with their services.

Richard Malfait and Nick Scott-Flynn (Independent Evaluators)

October 2018

R. Malfait Consultants (RMC) Ltd email: richardmalfait@aol.com Phone: 07808 297859

About the evaluation team: Richard Malfait (Director of R. Malfait Consultants Ltd.) and Nick Scott

Flynn have provided independent project evaluation, service development and interim management

services for organisations across the UK voluntary and statutory sector since 2001. Prior to this both

Richard and Nick were employed in a variety of operational and senior management roles based in

statutory and non-statutory support organisations, working directly with a range of vulnerable client

groups with often complex needs. Evaluation and consultancy clients have included small to medium

sized organisations and projects working locally with individuals and families experiencing poverty,

destitution, mental ill health and destitution. Other clients, often providing services on a wider UK or

overseas basis, include the British Red Cross, the Refugee Council and the Home Office, Action Aid,

the Refugee Council, Islamic Relief and VSO.

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